Who Really Wants Price Competition In Medicare Managed Care?

Abstract
There is much policy talk about making Medicare more competi- tive, like private markets. But when reform proposals near implementation, local opponents of competition are often able to stop reform experiments. This paper reports on one recent example, the Competitive Pricing Advisory Commit- tee, created by the 1997 Balanced Budget Act (BBA) to bring competitive bidding to Medicare+Choice plans. After design and site-selection choices were announced, members representing local interests were able to delay and per- haps kill competitive bidding before it could start, once again. A public report of this story may save future market-based Medicare reforms from a similar fate.

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